Provider Demographics
NPI:1720733322
Name:ELERA STAFFING, LLC
Entity Type:Organization
Organization Name:ELERA STAFFING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DASHEAVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOLLY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:478-978-3347
Mailing Address - Street 1:12550 CRENSHAW BLVD APT 219
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-3869
Mailing Address - Country:US
Mailing Address - Phone:478-978-3347
Mailing Address - Fax:
Practice Address - Street 1:1440 N HARBOR BLVD STE 916
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4127
Practice Address - Country:US
Practice Address - Phone:424-442-0290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251F00000XAgenciesHome Infusion
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No251E00000XAgenciesHome Health